Surgical snare and universal handle



July 17, 1923.

. E. C. DAY

SURGICAL SNARE AND UNIVERSAL HANDLE Filed June 20, 1921 INV WITNESSES@Mnmd ATTbEaNEV itres EMORY U. DAY, OF LAGUNA BEACH, CALIFORNIA.

SURGICAL SNARE AND UNIVERSAL HANDLE.

Application filed June 20, 1921. Serial No. 478,910.

Toa'll'whom itmayoonoem:

Be it lUlOWntl12LiJ'I,,EMORX DAY, a citizen of the United Statesresidingat Laguna Beach, in the county of Change and State ofiCalifornia,have-invented a new and useful Improvement in' surgicalSnares and Universal Handles, of which the following is a specification.

This inventionv has reference to surgical snares and universal handles,and its object isto provide an instrument for the removal: of tissues,either natural, such as normal tonsils, or pathological, such* as areenlarged" or diseased tonsils, and also tumors of various; characters.

The invention is of? especial value'for the removal 0t enlarged:tonsils,,a.nd, without limiting the use ofthe invention to anyparticular purpose, the following description Willlbe directed toconsidering the operation of the invention asapplied to the. removal ofenlarged or diseased tonsils.

In accordance with the invention, the usual snare is-iemployechsuch, forinstance,

as a strand of wire or the: like looped upon itself and passed througlnaguide, so; that when the loop is; drawn more or less into the guide, thediameter of the loop is reduced and is contracted about the cart ofthetonsil encircled thereby to causethe severing of the portion of thetonsil: to be removed quickly and effectively The guide is carried by a:handle, which may simulate a pistol grip, so that the operator may beenabledto firmly holdthe in strument, and carried by the handle is aslide capable of being reciprocateds on the handle.

The actuation of the snare is brought I about by lever mechanism, eitherdirectly or indirectly connected' toi said slide, and the latter.isinturn connected to the snare; The lever-actuating mechanism for thesnare is caused to operate in part on the principle of a lover of the:third order, such arrange- Inent permitting the holding of the body orhandle of the instrument firmly in one po sition againstthe wrist-end ofthe palm of the handof the operator, while the fingers of the; hand maythen, with a single squeeze or pull, accomplish the full actuation ofthe movingpant, the contractionnofj the loop of the. snare and theseverance of the tonsil;

This invention: is anvimprovement upon the surgical snare shown and"described in:

my application No. 847,156, filed December'24, 1919. i

The invention will be best understood from a consideration of thefollowing detailed description, taken in: co-nnection with theaccompanying drawings forming part of this specification, with theunderstandin, however, that the invention is not confined to any strict,conformity with the showing of the drawing, but may be changed. and?modified so long as such changes and modifications mark no materialdeparture from. the salient features of the invention asv expressedinthe appended claims.

In the drawings:-

Fig. 1 is a longitudinal section of the in .strument with some parts inelevation;

shown in Fig. 1

Fig. 3 is an elevation of the structure of Fig. l as viewed from theleft h'and endi of Fig. 1; i Fig. l is a section on. the line 41% of Fi1.

eferring to the drawing, there isshown a frame 1, which may be similarin outline to that of a pistol grip. This frame comprises a handhold 2,a top member or stock 3, and a bottom member 4, with the stock andbottom member extending forwardly from the handhold at opposite endsthereof, and with the stock of greater'length and forward extension thanthe bottom member. The stock 3 has a longtu'dinzrl slot 3 defined? bytwo spaced sides 3 and; 3; Pivoted to the forwardv end of the bottommember by a. pivot clamp screw 5. is the lower end of an' upstandinglever 6,. rising toward and at its upper end enteringthe stock 3. 1 a

Pivoted to the upper rear corner portion of the frame 1, by a pivotstuch 7 and: a screw 7 entering the stud; is one end of. a manipulatinglever 8, shown. as ofwslreleton form for lightness and strength andconsti tuting a leverof'the second order, said lever 8 entering at itspivoted end into theslht 3 in the top member or stock 3.

The lever 6 is an. elongated member with a slot (i' slengt'hwise thereofand of sufficient width to permit the passage through it of the otherlever B, which secondsnained lever; has a long hand-grip withOHBPOITtilOIl inthe form of a widenedislot 9 through which th'e fingersof the hand may be passed tot permit a firm hold upon the lever 8, andthat portion of the lever 8 extending through the slot 6 zinvthe lever6, is provided with a pivot screw 7.

The lever 6 carries a pin 11 traversing and slidable through the leverand extending throughthe slot 10, so that the two levers are joined bythe pin 11, which is movable with the lever 6 along the slot 10, andtravels along and in contact with one edge, (the outer edge), of theslot 10 when in operation, the active edge of the slot being designatedby the numeral 12. The pin 11 is carried by the outerend of a flat orleaf spring 13, the inner end of which is mounted on the pivotscrew 5,so that the pin 11 because of the yielding of the spring 13, may bereadily lifted out ofthe slot 10 to disengage the two levers, or may beentirely removed from the instrument on the removal of the screw 5. Thetwo-part top member or stock 3 ha matching longitudinal grooves 14 onthe inner faces of the two parts, and mounted in these grooves, andmovable along the slot 3 elongated block 15, forming a slide.

between the two parts of the stock, i's-Titn 1e block or slide 15 has abinding post 16 rising therefrom about midway of its length.

Depending from the block or slide 15, near the rear end thereof, is aslotted tongue 17, in the path of the free end 18 of the upper end ofthe lever 6, so that saidlever has its free end 18 so situated. as toengage the tongue 17, and thereby propel the slide 15 toward the handleend of the instrument.

At the front end of thestock 3, there is erected a post 19, carrying ascrew nipple 20, to which is applied a mutilated screw sleeve 21 of thebreech-block type, the screw nipple havin similarly arranged mutilatedscrewthrea s, so that the sleeve may be applied to or removed from thenipple by a partial turn. vThe sleeve 21 is provided with a radial slot22 for passing a tubular guide 23 throughthe slot 22 and the sleeve 21,and this guide is for the purpose of carrying a snare wire .24 extendingthrough the guide 23 and post 19 to the binding post 16 to which thesnare wire is ultimately secured, after being intermediately formed intoa loop 24 Carried by the sleeve 21 is a spring lug 25, capable ofengaging in notches or'dimples 26, in the adjacent face of the post 19,so that when the parts are assembled an'd'the sleeve 21. is turnedtightly, the engagement of the spring lug 25, in a notch or dimple 26,prevents the unintentional loosening of the sleeve. The constructionjust described is a variation ofth-econstruction shown in. my co-pendingapplication No. 478,909, and

which the hand grasping the hand-hold 2 may engage.

If it be considered that the slide 15 is pushed forward so that the loop2 1 in the snare wire 24, is expanded as far as may be necessary forapplication to a tonsil, or what ever is to be removed, the block 15participates in such movement along the slot 3 in a straight line, withthe ribs 14? traveling in the grooves 14 in the inside facingwalls ofthe stock. Under these circumstances, the lever 6 of the third class hasmoved about the pivot 5, with the upper end of the lever approaching theforward end of the stock, and the lever 8 is rocked forwardly for acorresponding distance. v

Now, after adjusting the expanded loop 2 1 of the snare wire about thetonsil to be removed, the lever 8 is drawn toward the hand-hold 2 by thefingers of the operator grasping the linger portion 9 of the lever 8,

with the palm of the hand located behind and against the hand-hold. Thelever 8 is moved about the pivot stud 7, and: at the same time causesmovement of the lever 6, because of the connection of the lever 6 to thelever '8 by way of the pin 11 passed through the slot 10. There is,therefore, set

up a simultaneous movement of the two" levers 6 and 8, constituting acompound lever, with the pin '11 joining them. and moving lengthwise ofthe slot 10 along the curved edge 12 thereof. a i

The movement of the manipulating lever 8 is toward the operator aboutthe pivot stud 7, and the impulse tending to con tract the loop 24 aboutthe tonsil is in the same direction, that is, toward the operator,

and because of the curvature ofthe slot 12, the force tending tocontract the loop is an increasing force corresponding to the increasingresistance met by the loop, wherefore the'steadiness'of the operation ofthe instrument is in no wise affected thereby.

The sliding block with its binding post 1 moving in and along the slot 3of the stool: contributes to the steadiness of the instrument especialyin connection with the groov ing of theslidable block to'allow theflange of the lever 8 to rise higher about its pivot 9 7 than wouldoccur were the groove absent,

the groove in the block being indicatedat s The guide 23 is'removablyheld in the post i 19 so as to make wavrfor accessory surgicalinstruments when the device is used as a only. The substituteoraccessory surgical instruments may include scissors, forceps, punches,etc. i Y a i j The device of this invention has the advantage over thatof theoompanion appli cation for the universal handle, in that it has agreater range of movement, and because of the combination of types oflevers IDtO a compound le-ver, constitutes amore pivoted at its upperend to the frame and entering the slot of the first-mentioned lever,said manipulating lever having a curved slot, and a pin passing throughthe first- 4 mentioned lever and extending through the curved slot ofthe manipulating lever so as to join the two levers together, and aslide actuated by the movement of the upstanding lever.

2. A surgical snare comprising abody portion having a hand-holdcorresponding to a pistol grip with a stock carried bv and pro jcctingfrom the hand-hold, said hand-hold also having a forwardlyprojectingportion at the end remote from the stock, a slide carried bythe stock and guided therealong, an upstanding lever pivoted at one endto the forward end of the lower projection of the hand-hold and at theupper end engaging the slide to propel it, and slotted lengthwisethereof and another lever pivoted at the upper end to therear portion ofthe stock and entering the slot of the upstanding lever and engaging thesaid lever between its ends whereby the two levers constitute a compoundlever for actuating the slide and the latter having means for theattachment oi surgical devices thereto.

3. A surgical snare comprising a body portion including a hand-hold witha forwardly projecting lower end, a stock fast at the rear end to theupper end of the handhold and also projecting forwardly, said stockhaving spaced side members with matching grooves n the facing portion, aslide mounted in the stock and guided by the groove to move therealong,and a compound lever with one element pivoted to the forward end of thelower projection of the handhold and rising into engaging relation, tothe slide and the other elementbeing pivoted to the rear end of anddepending from the stock and the two elements of the compound leverbeing connected by a sliding pivot, and a second-named elementvof thesenses compound lever having finger-holds, where by the hand oftheoperator may grasp the hand-hold in the palm of thehand with "thefingers engaging the finger-hold of the" second-named element of thecompound lever to move the block with increasing.

force toward the operator. i i

4. A. surgical snare comprisinga'body portionincludinga hand-holdwith aform; wardly projecting lower end, a stock fast at the rear end to theupper end of the w'hand-hold and also projecting forwardly, saidstockhaving spaced side members with matching grooves on the facingportion, a

slide mounted in the stock and guided by the groove to move therealong,and a compound lever with one element pivoted to the forward end of thelower projection of' the hand-hold and rising into engaging relation tothe slide and the other element being pivoted to the rear end of anddepending from the stock and the two elements of the compound leverbeing connected by a sliding pivot, and a second-named element of thecompound lever having finger-holds, whereby the hand of the operator maygrasp the hand-hold in the palm of the hand a a with the fingersengaging the finger-hold of the second-named element of the compoundlever to move the block with increasing force toward the palm of thehand of the operator, the second-named element of the compound leverbeing provided with an extended slot, having a curved working edge and aconnecting pin between the two lever elements and traversing the slot tomove along said curved working edge" 5. In a surgical snare or likeinstrument, a body member, comprising a hand-hold simulating a pistolgrip with a lower forward extension and a stock at the upper end of thehand-hold extending forwardly to a greater extent than the hand-hold,said stock having a longitudinal slot therepalm of the hand of thethrough with guiding grooves on opposite sides, aslide mounted in andmovable lon gitudinally of the slot and held therein by the grooves, alever structure comprising two elements, one pivoted in the stock nearthe rear end and the other pivoted to the forward extension of thehand-hold and the two elements having a sliding pivoted connectionintermediate of their lengths and the. compoundlever being connected tothe slide toactuate it'by thehand of an operator grasping the hand-holdand one a member of the compound lever, and means whereby the levers andparts with which they coact are retained removably on the body member.

6. A surgical snare, comprising a suitable handle provided with a stock,a screw nipple at the forward end of the stock,a mutilated screw sleevefor rapid release thereof from the stockand provided with a radial slot,

a tubular guide for lateral introductionintoth'e slot; a spring lugradial to the sleeve, anda post at theouter end of the stock andhaving-notches to receive and temporarily lock thesp'r'ing lug."

7.; surgicalusnare COII1PI1SlI1g'3, suitable handle provided with astock, a screw nipple on the stockhavingmutilated screw threads,

mutilated screw sleeve applied to .or removed from the nipple byapartial turn,

said sleeve having a radial slot, a tubular guide carrying the" snarewire, said guide. adapted to be passedthrough the'slot, and

means whereby when the sleeve is turned tightly on the nipple theaccidental loosening of the sleeve is preventedw In testimony thatnature.

may be applied to or removed from-the fixed part by a partial turn, themovable part having a radial slot, a guide of a size to be passed intothe slot. and held by the movable part awspring lug carried by the mov--able part and depending therefrom, and

vent the accidentalloosening of the movable part.

as my own,I havehereto aflixed my sig- I claim the foregoing EMORY 0.DAY.

'notchesto be engaged by the lug to prea

